Driving pressure in acute respiratory distress syndrome for developing a protective lung strategy:A systematic review  

作　　者：Hassan A Alzahrani Nadia Corcione Saeed M Alghamdi Abdulghani O Alhindi Ola A Albishi Murad M Mawlawi Wheb O Nofal Samah M Ali Saad A Albadrani Meshari A AlJuaid Abdullah M Alshehri Mutlaq Z Alzluaq 

机构地区：[1]Department of Respiratory Care,Medical Cities at the Minister of Interior,Riyadh 13321,Saudi Arabia [2]Interventional Pulmonology,Antonio Cardarelli Hospital,Naples,Italy [3]Department of Clinical Technology,Respiratory Care Program,Umm-Al Qura University,Makkah al Mukarramah 21599,Saudi Arabia [4]Respiratory Therapy Unit,Security Forced Hospital Program,Makkah al Mukarramah 26955,Saudi Arabia [5]Department of Medical Affairs,Security Forced Hospital Program,Makkah al Mukarramah 25911,Saudi Arabia [6]Department of Intensive Care Unit and Medical Affairs,Security Forced Hospital Program,Makkah al Mukarramah 23455,Saudi Arabia [7]Department of Pharmacy,Security Forced Hospital Program,Makkah al Mukarramah 23455,Saudi Arabia [8]Department of Internal Medicine,Security Forced Hospital Program,Makkah al Mukarramah 21955,Saudi Arabia [9]Department of Respiratory Therapy,King Faisal Medical Complex,Taif 29167,Saudi Arabia [10]Department of Respiratory Therapy,King Fahad,General Hospital,Taif 29167,Saudi Arabia [11]Department of Respiratory Therapy,East Jeddah Hospital,First Jeddah Cluster,Jeddah 23235,Saudi Arabia

出　　处：《World Journal of Critical Care Medicine》2025年第2期158-169,共12页世界重症医学杂志(英文)

摘　　要：BACKGROUND Acute respiratory distress syndrome(ARDS)is a critical condition characterized by acute hypoxemia,non-cardiogenic pulmonary edema,and decreased lung compliance.The Berlin definition,updated in 2012,classifies ARDS severity based on the partial pressure of arterial oxygen/fractional inspired oxygen fraction ratio.Despite various treatment strategies,ARDS remains a significant public health concern with high mortality rates.AIM To evaluate the implications of driving pressure(DP)in ARDS management and its potential as a protective lung strategy.METHODS We conducted a systematic review using databases including EbscoHost,MEDLINE,CINAHL,PubMed,and Google Scholar.The search was limited to articles published between January 2015 and September 2024.Twenty-three peer-reviewed articles were selected based on inclusion criteria focusing on adult ARDS patients undergoing mechanical ventilation and DP strategies.The literature review was conducted and reported according to PRISMA 2020 guidelines.RESULTS DP,the difference between plateau pressure and positive end-expiratory pressure,is crucial in ARDS management.Studies indicate that lower DP levels are significantly associated with improved survival rates in ARDS patients.DP is a better predictor of mortality than tidal volume or positive end-expiratory pressure alone.Adjusting DP by optimizing lung compliance and minimizing overdistension and collapse can reduce ventilator-induced lung injury.CONCLUSION DP is a valuable parameter in ARDS management,offering a more precise measure of lung stress and strain than traditional metrics.Implementing DP as a threshold for safety can enhance protective ventilation strategies,po-tentially reducing mortality in ARDS patients.Further research is needed to refine DP measurement techniques and validate its clinical application in diverse patient populations.

关 键 词：Acute respiratory distress syndrome Mechanical ventilation Driving pressure Respiratory care Intensive care unit Pulmonary disease 

分 类 号：R563.8[医药卫生—呼吸系统]